SAN DIEGO — Morbidly obese patients who underwent gastric banding had a 60% lower risk of death at 5 years than a group of morbidly obese patients who did not undergo any obesity surgery, results from a large Italian study demonstrated.
Dr. Luca Busetto and his associates studied 821 consecutive patients with a body mass index of greater than 40 kg/m
The mean age of patients was 25 years, Dr. Busetto reported at the annual meeting of the American Society for Bariatric Surgery. The mean follow-up was 5.6 years in the gastric banding group and 7.2 years in the nonsurgical group. Vital status upon study entry was available for 91% of patients in the gastric banding group and in 97% of patients in the nonsurgical group.
Eight deaths occurred in the gastric banding group, compared with 36 deaths in the nonsurgical group, for a total mortality of about 1% and 4%, respectively.
The rate of revisional surgery in the gastric banding group was 13%. The percent of weight loss in this group peaked at 42% in the second year of follow-up and remained stable up to 6 years after surgery.
Multivariate analysis revealed that gastric banding conferred a 60% reduced risk of death, compared with patients in the nonsurgical group. “The reduction in mortality by [gastric] banding seems to be more pronounced in women than in men, in middle-aged than in younger patients, and in superobese than in morbidly obese patients,” Dr. Busetto commented. “However, the number of events observed in the two groups was generally low. Therefore, the results of this subgroup analysis should be interpreted very cautiously.”
He acknowledged that the differences in mortality between the two groups of patients “may be due to some difference in baseline clinical status that remains undetected in our study, in particular the difference in comorbidities.”
Dr. Busetto disclosed that he is a consultant for Allergan and Medtronic. He also is a speaker for Abbott Laboratories.
The number of events observed was generally low. Therefore, the results should be interpreted 'very cautiously.' DR. BUSETTO